JMIR Rehabilitation and Assistive Technologies最新文献

{"title":"Ankle Bracelet Laser as a Novel Portable Device to Improve Walking in Patients With Parkinsonism: Randomized Crossover Controlled Trial.","authors":"Peeraya Ruthiraphong, Kwan Srisilpa, Chompoonuch Ratanasutiranont","doi":"10.2196/70209","DOIUrl":"https://doi.org/10.2196/70209","url":null,"abstract":"<p><strong>Background: </strong>Freezing of gait (FOG) is a common and debilitating symptom of parkinsonism. Although visual cues have proven efficacy in alleviating FOG, most current visual cues are fixed in place, restricting their use to controlled environments such as clinics or homes. Mobile open-loop cueing devices have been developed to address this limitation; however, they typically require manual activation to deliver the visual cues, which can be particularly challenging for patients with attention or cognitive impairments, leading to equivocal results in improving gait performance.</p><p><strong>Objective: </strong>The aim of the study is to assess the efficacy of an ankle bracelet laser, a new mobile visual cue designed for practical use, in improving gait performance in patients with parkinsonism and FOG.</p><p><strong>Methods: </strong>A randomized controlled 2-period crossover trial was conducted from June 15, 2020, to October 1, 2020, at Ramathibodi Hospital. In total, 10 patients with parkinsonism and FOG were enrolled in 2 conditions: walking with laser-off first and walking with laser-on first. Gait speed, the timed up and go test, stride length, and the locomotor rehabilitation index were assessed twice in each trial with a 10-minute washout period.</p><p><strong>Results: </strong>The results showed favorable improvement in all parameters. Gait speed and stride length improved by 0.07 m/s (95% CI 0.04-0.09 m/s; P<.001) and 0.17 m (95% CI 0.11-0.23 m; P<.001), respectively, with laser-on. The timed up and go test duration was reduced by 7.69 seconds (95% CI 2.82-12.55 seconds; P=.002). The locomotor rehabilitation index improved by 4.46% (95% CI 2.56%-6.36%; P<.001). When using the device, there were no adverse effects, such as dizziness or blurred vision.</p><p><strong>Conclusions: </strong>The ankle bracelet laser cue produced immediate improvements in gait speed, stride length, and balance in patients with parkinsonism and FOG, suggesting that the device can acutely enhance gait performance. Further research is needed to determine whether these benefits are sustained and applicable to daily life activities.</p><p><strong>Trial registration: </strong>Thai Clinical Trials Registry TCTR20210511001; https://www.thaiclinicaltrials.org/show/TCTR20210511001.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e70209"},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home-Based Augmented Reality Exercise For People With Parkinson Disease: Qualitative Acceptability Study.","authors":"Lotte E S Hardeman, Esther van Benten, Eva M Hoogendoorn, Maaike van Gameren, Jorik Nonnekes, Melvyn Roerdink, Daphne J Geerse","doi":"10.2196/70802","DOIUrl":"https://doi.org/10.2196/70802","url":null,"abstract":"<p><strong>Background: </strong>The rising prevalence of Parkinson disease and the growing demand on the health care system underscore the need for accessible and innovative care solutions, such as Reality Digital Therapeutics (Reality DTx)-an augmented reality neurorehabilitation program that delivers remotely prescribed gait and balance exercises for people with Parkinson disease to perform at home.</p><p><strong>Objective: </strong>At a preimplementation stage, this qualitative study aimed to explore the acceptability of Reality DTx.</p><p><strong>Methods: </strong>An exploratory qualitative study design was used. We conducted semistructured interviews, guided by the theoretical framework of acceptability, with 22 people with Parkinson disease who used Reality DTx at home for 6 weeks as part of a feasibility trial. We conducted a reflexive thematic analysis using an inductive, semantic approach informed by critical realism.</p><p><strong>Results: </strong>The results of the reflexive thematic analysis are described in 3 themes and 9 subthemes. The 3 themes are \"there was considerable interindividual variation,\" \"the intervention is complementary to supervised physical therapy,\" and \"adherence in the long term is crucial.\" Participants reported variable perceptions of effectiveness and variable experiences of effort to complete the Reality DTx program. They viewed Reality DTx as a valuable complement to supervised physical therapy and emphasized the indispensable role of the physical therapist for external control of long-term exercise adherence and for meaningful feedback on motor performance, as well as the desire for social connection. Flexibility in time and location was mentioned as a very important program characteristic, supporting long-term exercise adherence. Suggestions for improvement included enhanced visibility of progression in scores, increased variation in games, and the integration of competitive elements.</p><p><strong>Conclusions: </strong>Remotely prescribed, gamified, augmented reality exercises at home, complementary to supervised physical therapy, are acceptable to people with Parkinson disease. The findings inform future Reality DTx development and implementation from the perspective of people with Parkinson disease, which should be weighted with the perspectives of other stakeholders such as clinicians and other key decision-makers.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e70802"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Technology-Assisted Rehabilitation After Spinal Cord Injury: Pilot Randomized Controlled Crossover Trial.","authors":"Mia Maria Kilkki, Joonas Poutanen, Kari Kauranen, Jari Arokoski, Sinikka Hiekkala","doi":"10.2196/78091","DOIUrl":"10.2196/78091","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Technology-assisted and robotic rehabilitation methods are increasingly used in neurorehabilitation. Still, scarce evidence exists on their effects on upper extremity functioning after spinal cord injury, especially at the chronic stage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The present study aims to evaluate the effects of a 6-week intervention focusing on technology-assisted upper extremity rehabilitation in adults 1-8 years after incomplete cervical spinal cord injury.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this pilot randomized controlled crossover trial, 20 participants (10 men, 34-73 y of age) were recruited by mail and randomized into 2 sequences (AB: n=10 and BA: n=10). All participants received a 6-week rehabilitation intervention in Period 1 or Period 2, with a 4-week washout period in between. The intervention was delivered 3 times a week for 6 weeks (18 sessions) by occupational therapists specialized in spinal cord injuries. Each 1-hour therapy session included a minimum of 30 minutes of technology-assisted upper extremity rehabilitation using interactive and task-specific AMADEO, DIEGO, or PABLO devices. Other occupational therapy activities were allowed to complete the 1-hour therapy session. The effects of the 6-week rehabilitation intervention were compared with 6 weeks of no intervention, and the analyses were based on paired data. Each participant served as their own control. Hand and arm function were evaluated using the Action Research Arm Test, the American Spinal Injury Association-Upper Extremity Motor Score (ASIA-UEMS), grip strength, pinch strength, and the Spinal Cord Independence Measure-Self Report. Rehabilitation goal attainment was evaluated by the Goal Attainment Scale. Face-to-face assessments were conducted at baseline, after Period 1, after Period 2, and at 6 months, except for the Goal Attainment Scale, which was used at the beginning and immediately after the rehabilitation intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The effects of the rehabilitation intervention compared to no intervention were statistically insignificant, except for the ASIA-UEMS (median change 1, IQR 0-2 point versus 0, IQR -2 to 0 point) in participants in sequence BA (n=7) who received the rehabilitation intervention during Period 2 (P=.04). The rehabilitation intervention showed good feasibility and tolerability in adults with incomplete cervical spinal cord injury. Of 20 participants (median age 62, IQR 58-66 y), 19 enrolled in the study, and 17 completed at least 80% of the rehabilitation sessions. Fourteen out of 16 participants included in the final analysis attained their rehabilitation goals. The goals were mainly focusing on \"fine hand use\" and \"hand and arm use\" related to self-care and domestic life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Results of this pilot study suggest that technology-assisted upper extremity rehabilitation provided by occupational therapists is safe and has potential for broader clin","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e78091"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Self-Efficacy Through Robotic Safety Support in Balance-Challenging Reach Tasks: Feasibility Study in Young Adults.","authors":"Daiki Shimotori, Soshi Fujisawa, Masahiro Nishimura, Tatsuya Yoshimi, Kenji Kato","doi":"10.2196/81263","DOIUrl":"https://doi.org/10.2196/81263","url":null,"abstract":"<p><strong>Background: </strong>Falls and fear of falling adversely affect the quality of life and independence of older adults. Although various robotic systems have been developed for fall prevention, their psychological effects, particularly on self-efficacy, remain underexplored. A ceiling-mounted fall impact mitigation robot offers continuous protection with almost no limitations on the range of movement; however, its impact on users' psychological state and functional performance is unclear.</p><p><strong>Objective: </strong>This study aimed to evaluate the effect of a fall impact mitigation robot on psychological reassurance and task performance during dynamic balance tasks in healthy young adults, with a focus on self-efficacy and functional reach capacity.</p><p><strong>Methods: </strong>Twenty-four healthy adults (age: mean 28.9, SD 7.9 years) were randomly assigned to experimental (n=12) or control (n=12) groups. All participants performed a baseline functional reach test, followed by a series of progressively challenging reach tasks (starting at 98% of maximum reach and increasing by 2% until failure). The experimental group performed tasks while wearing the fall impact mitigation robot; the control group performed without it. Self-efficacy ratings (-5 to +5 scale) were recorded before each trial. Center of pressure (COP) data were continuously collected. Statistical analyses included Mann-Whitney U tests for self-efficacy, Kaplan-Meier survival analysis for task performance, and t tests for functional reach test and COP changes.</p><p><strong>Results: </strong>During reach trials ≥102% of baseline, the experimental group (median 1.0, IQR 0.0 to 3.0) reported significantly higher self-efficacy ratings than did the control group (median 0.0, IQR -1.0 to 2.0; U=1292.5; P=.047). However, no significant differences were observed in changes in functional reach capacity (experimental: mean 104.2%, SD 3.8%; control: mean 103.6%, SD 2.5%; P=.62) or COP displacement (experimental: mean 108.9%, SD 10.4%; control: mean 114.1%, SD 9.8%; P=.23). Survival analysis revealed a nonsignificant trend toward greater task persistence in the experimental group (χ²₁=0.36, P=.55).</p><p><strong>Conclusions: </strong>The fall impact mitigation robot significantly improved self-efficacy during challenging balance tasks, despite providing no active physical support. These findings underscore the role of psychological reassurance in modulating balance-related behavior and suggest that robotic safety systems may influence motor performance through psychological mechanisms. Integrating psychological support into robotic fall prevention strategies may enhance their effectiveness.</p><p><strong>Trial registration: </strong>UMIN Clinical Trials Registry UMIN000049284; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000056126.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e81263"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capturing Objective Functional Measures Using Smartphone Inertial Sensors: Feasibility and Usability Study With Older Adults.","authors":"Christian Kempton, Kate Ryan, Sophie Clohessy, Peter Grinbergs, Mark T Elliott","doi":"10.2196/72511","DOIUrl":"10.2196/72511","url":null,"abstract":"<p><strong>Background: </strong>Digital platforms and smartphone apps have the potential to help patients with musculoskeletal conditions receive targeted interventions and physiotherapy support at home. As musculoskeletal conditions are much more prevalent in older adults, it is important to determine whether these technologies are accessible and acceptable to this demographic, who may possess lower levels of digital literacy compared to younger adults.</p><p><strong>Objective: </strong>The study aims to evaluate the feasibility and usability of completing functional assessments while recording the activity using smartphone inertial sensors in adults 60 years or older.</p><p><strong>Methods: </strong>Participants (N=21) were recruited from a range of community settings to complete a 4-week home-based trial, recording unsupervised sit-to-stand and single-leg balance activities at least once per week using their smartphone. We analyzed the data quality and adherence by number of assessments per week from the uploaded datasets. Feedback on usability was assessed using interviews and the System Usability Score.</p><p><strong>Results: </strong>Inductive content analysis was used to identify 5 top-level categories: app, device, task, time, and personal perception. The mean System Usability Scale score was 81.2 (SD 17.5). The proportion of valid data uploads was 63.8% (81/127) for single-leg balance and 93.5% (58/62) for sit-to-stand measures. Adherence was high, with no significant deviations in the mean number of sessions completed or duration between sessions.</p><p><strong>Conclusions: </strong>Smartphone-based monitoring of functional activities can facilitate unsupervised, remote assessments, thus reducing burden on physiotherapy services and increasing the ability to monitor progress objectively. Activities should be considered for complexity and, where necessary, increase in difficulty over time. App-based feedback is essential to inform users of the progress and adherence to the activities.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e72511"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usability of Videoconferencing for Physical Exercise Interventions in Older Adults: Scoping Review.","authors":"Louise Robin, Stéphane Mandigout, Charles Sebyio Batcho, Axelle Gelineau, Benoit Borel","doi":"10.2196/65552","DOIUrl":"10.2196/65552","url":null,"abstract":"<p><strong>Background: </strong>Videoconference combines the convenience of home-based physical exercise (PE) with group interaction and supervision of exercise in the community and could be useful for facilitating PE practice among older adults.</p><p><strong>Objective: </strong>This scoping review aims to assess the evidence regarding the usability of videoconferencing technologies. Specifically, it explores whether tele-exercise solutions based on videoconferencing are usable for older adults and professionals, and how the heterogeneity of evaluation tools influences the generalization of results.</p><p><strong>Methods: </strong>Electronic searches were conducted in databases Pubmed-Ovid Medline, Science Direct, Scopus, and CINAHL from January 2000 to March 2025 for identifying articles on measures of usability (ie, effectiveness, efficiency, and satisfaction of technology).</p><p><strong>Results: </strong>A total of 14 studies out of 2506 unique records were included. The results showed that videoconferencing strategies can effectively deliver synchronous exercise interventions. However, their effectiveness, efficiency, and user satisfaction vary depending on the technological medium used. Despite widespread use among older adults, there is a notable gap in studies evaluating usability, particularly regarding remote PE interventions.</p><p><strong>Conclusions: </strong>The review highlights that videoconferencing can be an effective tool for delivering synchronous exercise interventions to older adults. However, the effectiveness and user satisfaction depend on the technology used and the individual's characteristics. Further studies using standardized evaluation tools are needed to better assess usability. These findings underscore the importance of continued research to evaluate the effectiveness and acceptability of videoconferencing technologies for exercise interventions and to develop customized solutions to optimize the efficacy of these interventions for this population.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e65552"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing Smart Televisions as Assistive Technology to Enhance Communication and Social Lives of Older Adults: Systematic Review.","authors":"Jayde Langdon, Cristina Tugahan Cabansag, Alexis Grigoris, Way Kiat Bong","doi":"10.2196/73050","DOIUrl":"10.2196/73050","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Over the past decade, the proportion of the world's population aged ≥65 years has grown exponentially, presenting significant challenges, such as social isolation and loneliness among this population. Assistive technologies have shown potential in enhancing the quality of life for older adults by improving their physical, cognitive, and communication abilities. Research has shown that smart televisions are user-friendly and commonly used among older adults. However, smart televisions have been underutilized as assistive technologies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to explore the state of the art in using smart televisions as assistive technologies to enhance communication and social interactions among older adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The search was conducted following the guidelines for performing a systematic literature review, which included 6 databases, that are, the IEEE, ACM, Google Scholar, ScienceDirect, Engineering Village, and Springer. A range of keywords were used in different combinations, including \"smart TV,\" \"older adults,\" \"elderly,\" \"communication,\" \"messaging,\" \"video call,\" and \"application.\" A set of inclusion and exclusion criteria was defined before the search, and the screening was performed by 3 researchers. We analyzed the selected articles in accordance with the review's aim and the established inclusion and exclusion criteria. None of the articles were subjected to quantitative synthesis because of the significant variations in the data measured.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After screening 2671 records from the abstract level to full text, 30 articles were identified as relevant studies, demonstrating both direct and indirect impacts on the social lives of older adults through the use of smart televisions as assistive technology. Some articles were part of the same or larger studies, which makes the number of actual projects even smaller. This indicates that smart televisions have been underutilized as assistive technologies for enhancing older adults' communication and social lives. More than half of the articles proposed their own prototype, and these prototypes were primarily targeted for use at home, while some were targeted for use at geriatric care units or nursing homes. User involvement among older adults was high among the included articles, and some also included other users, such as health care personnel, administrative staff, and engineers. The included studies were mostly from Europe.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This review highlights the potential of smart televisions as assistive technologies to enhance social connectivity among older adults, and identifies several research gaps. Most studies focus on short-term usability and are geographically limited to Europe. Future research should include longitudinal studies, explore diverse cultural attitudes, and focus on adaptive solutions for various health conditions. We hope this revi","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e73050"},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Socially Assistive Robots in Physiotherapy: Scoping Review.","authors":"Jiaxin He, Melanie K Farlie, Pamela Carreno-Medrano","doi":"10.2196/69908","DOIUrl":"10.2196/69908","url":null,"abstract":"<p><strong>Background: </strong>Socially assistive robots (SARs) are robotic technology platforms equipped with sensing (eg, through audio or visual) and acting (eg, speech and movement) capabilities to interact socially with users. SARs are increasingly adopted in physiotherapy to aid patients in their rehabilitation journey by providing feedback, motivation, and encouragement. However, while many studies have explored SAR implementation in physiotherapy, research involving clinical populations remains scarce, and the overall state of SAR deployment is unclear.</p><p><strong>Objective: </strong>This scoping review aimed to explore the use of SARs in physiotherapy with clinical populations, how the effectiveness of these interventions has been evaluated, and identify limitations and new areas of application and future work.</p><p><strong>Methods: </strong>Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-analyses for Scoping Review) reporting guideline extension, comprehensive searches based on SARs and physiotherapy were conducted in various databases. Title and abstract screening were performed by 1 reviewer, with full-text screening conducted by 2 reviewers. Data extraction, synthesis, and analysis were completed by 1 reviewer. Data on SAR roles were categorized and synthesized using content analysis. Other descriptive texts were summarized to improve readability.</p><p><strong>Results: </strong>Our findings suggest that SARs are commonly used in rehabilitation clinics and hospital inpatient settings, primarily for neurological conditions. In these interventions, SARs typically serve roles, such as coaching, demonstration, monitoring, and peer support. Their effectiveness is generally evaluated through clinical outcomes, user performance, functional measures, and metrics assessing the robots' acceptability, usability, and perception.</p><p><strong>Conclusions: </strong>This scoping review highlighted SARs' potential to address challenges faced by human therapists due to the demands of time-extending coaching and monitoring and the limited availability of therapists. Future research should focus on addressing the limitations identified in this scoping review, including small sample sizes, technical issues in both the robot and intervention design, sufficient involvement of key stakeholders in the design and development of SAR-based interventions, and conducting more clinical trials to investigate SAR intervention effectiveness.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e69908"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12407224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Speech and Language Therapists' Perspectives of Voice-Assisted Technology as a Tool for Dysarthria: Qualitative Study.","authors":"Jodie Mills, Orla Duffy, Katy Pedlow, George Kernohan","doi":"10.2196/75044","DOIUrl":"10.2196/75044","url":null,"abstract":"<p><strong>Background: </strong>People living with Parkinson disease (PD) often experience low speech volume and reduced intelligibility. Research suggests that common voice-assisted technology (VAT) devices, like Amazon Alexa and Google Home, can encourage individuals to modify their speech, speaking more clearly, slowly, and loudly. This highlights the potential of VAT as a therapeutic clinical tool in speech and language therapy (SLT). However, while VAT is emerging as a novel health care technology, gaps exist regarding understanding speech and language therapists' (SaLTs) experiences using these devices in clinical practice for PD-related speech and voice difficulties.</p><p><strong>Objective: </strong>This research set out to explore various experiences of using VAT to address hypokinetic dysarthria, secondary to PD, from a range of stakeholder perspectives. This paper specifically focuses on clinical insights from SaLTs.</p><p><strong>Methods: </strong>SaLTs with prior experience of using smart speakers in clinical practice with people with speech or voice difficulties were invited to participate in focus groups or interviews. Between September and December 2024, seven SaLTs participated in semistructured focus groups or interviews using a topic guide. Discussions were informed by published evidence. Results were transcribed and analyzed using a framework analysis approach and were managed through NVivo software (Lumivero).</p><p><strong>Results: </strong>Four main themes were identified across the groups: (1) potential for VAT in SLT, (2) managing therapeutic beige flags, (3) empowering SaLTs to become digitally enabled practitioners, and (4) envisioning the future of VAT in SLT.</p><p><strong>Conclusions: </strong>This study recognizes VAT's potential as a therapeutic tool that may improve volume, clarity, intelligibility of speech, and facilitate at-home practice for people with PD. However, before VAT can be widely implemented, considerations around data privacy, device limitations, and practical integration into clinical care must be addressed. Future research is proposed to design solutions to address usability challenges for both clients and clinicians. Finally, this paper offers key clinical recommendations for the development of a therapeutic VAT tool for speech and voice difficulties in SLT.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e75044"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home-Based mHealth Platform (Active-Feet) for Children With Idiopathic Toe Walking: Design, Development, and Acceptability Study.","authors":"Miguel Membrilla-Mesa, Jose Heredia-Jiménez, Carla Di Caudo, Maria Almudena Serrano-Garcia, Yolanda Archilla Bonilla, Angel Ruiz-Zafra, Kawtar Benghazi-Akhlaki, Manuel Noguera-Garcia, Alberto Ortiz de Andres, Simon Perez-Garcia, Rocio Pozuelo-Calvo","doi":"10.2196/60867","DOIUrl":"10.2196/60867","url":null,"abstract":"<p><strong>Background: </strong>Physical exercise and stretching programs are the best initial options to treat idiopathic toe walking (ITW). These programs are designed to improve the flexibility and strength of lower limb muscles, enhancing the ankle's range of motion and allowing for a normal gait pattern. In the pediatric population, one of the major limitations reported by therapists is low adherence to rehabilitation treatments or a lack of follow-up. In this context, children using mobile health (mHealth) tools could play an active and central role in their treatment of ITW, while mobile apps could also allow for daily monitoring by health care professionals.</p><p><strong>Objective: </strong>This study aims to design and develop a mHealth platform for individuals with ITW. In addition, a feasibility and acceptance test of a home-based exercise program was conducted using a comprehensive mobile app intended to improve walking in children with ITW.</p><p><strong>Methods: </strong>This study describes the context, content preparation, and mHealth platform design, as well as subsequent evaluation using a self-administered satisfaction questionnaire. Initially, the main features of the Active-Feet platform were discussed, focusing on its primary goal of helping children with ITW adhere to the rehabilitation program. However, this study did not evaluate the platform's effectiveness in improving adherence or ankle range of motion. A set of 3D avatars consisting of animated characters was designed. Posterior muscle chain stretching exercises were selected following the main guidelines. The Active-Feet development process was carried out in 5 stages: requirements specification, platform design, platform implementation, platform deployment, and alpha testing of the app.</p><p><strong>Results: </strong>The final version of the Active-Feet app was evaluated from both the parents' and children's perspectives. Twenty patients and 1 parent per child assessed the app over 2 weeks and answered specially designed questionnaires. Parents rated the app's impact on their child's motivation and its overall effectiveness highly, with median scores of 4 (IQR 4-4). Notably, the item related to reconciling family life with rehabilitation treatment received a median score of 5 (IQR 4-5). Children's responses also indicated positive ratings for motivation and user-friendliness, with a median score of 4 (very good; IQR 3.25-4). Questions about the app's impact, helpfulness in learning, and exercise mirroring received a median score of 3 (good; IQR 3-4).</p><p><strong>Conclusions: </strong>This study describes the development process and testing of Active-Feet, an mHealth-based platform designed to offer treatment for children with ITW. After the long process, an attractive and easy-to-use platform for ITW was developed for the first time.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e60867"},"PeriodicalIF":0.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}